EPC Question

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Hello All

Just a quickie............ I have knowledge of four podiatry employers in Australia. Two of them tell me that the amount of EPC treatments counts from the date of referral from the GP. The other two tell me it is per calendar year - i.e. from Jan to Dec.

Can anyone give me a definite answer please!?

Regards

TB

 

I have just been informed it is JAN-DEC. The logical way would be via date of referral....bonus for those who get their referrals in November and can have 5 visits in 8 weeks!!!

Sometimes the system is a parody of itself....

 

Confusing yes...we were told originally from date of referral - however recently we were told from calendar year which is silly! Im going with date of referral and thats what we are continuing to do - havent had any upsets yet about it.

 

Hi

Thanks a lot both of you. Just wondering who it was that told you - was it an official Medicare person or just another pod who is as confused as the rest of us?!!

TB

 

From my understanding of the Medicare advice, the patient is entitled to 5 EPC visits in total for all AH disciplines combined per calendar year regardless when the referral is dated.

This gets confusing for both patients and practioners when the referral date does not match up to calendar year, for example patient could be referred in March 2009 and uses 3 out of 5 visits by 31 December 2009, they still have 2 visit left, which can be used anytime from January to March 2010 when the referral is renewed in March 2010. When the referral is renewed they can then only use 3 visits for the remainder of 2010 on the new referral, as they are limited to 5 visits in a calendar year. By now I have probably confused you.

The easiest thing to do if you are not sure is to phone Medicare on 132 150 and enquire if the patient has a current entitlement before commencing the treatment. Medicare will need your provider details and the Medicare details of your patient.

Hope this helps.

Cheers,
Craig

 

This is correct. See the HIC website for confirmation.

Max. 5 visits per calendar year, with referral expiry at the end of the following year. Did someone say contradiction?

As usual differring podiatrists/AHPs believe one thing, the GPs another, and various members of HIC/Medicare staff believe yet another. The poor patient inevitably doesn't know who to believe.

The stupidity of this complex situation is only matched by the outrageous fees paid to GPs for pushing a button to generate a Care Plan.

LL

 

As it seems not even Medicare staff understand their system, our secretary spent an hour with a medicare manager recently, as advice given to us and pts is always variable.

So simple advice is take their money give them their receipt and them on their way to medicare and then rapidly lock all dorrs and windows and flee the country.igs:

That way you will not be subject to verbal and physical assault from pt when they do not get their refund.:butcher:

Seriously though no one seems to understand the system, including GP's who insist it is free, and even reading the book of words is no clearer.

It seems both calendar and financial year is used accordint the phase of the moon.:deadhorse:

regards David confused after 3 years of working here

 

Hmmm...

Dave,

I have been criticized here before for my view, yet will restate it in any case and weather the critique...

Australian Pods....we are all (hopefully) super busy, simply decline to participate in the EPC system as I do, why?

1. It supports GP dominance
2. It reinforces a supplementary role that none of us entered the profession to pursue
3. When it all goes wrong, we get abused - not the GP who promotes us as 'free' service providers
4. It reinforces (for the 'bulk-billers') the notion of 'free' (read not valued) health care, i.e. if we are free/cheap we are of no intrinsic worth
5. As a profession, we don't need it - too few Pods to service the communities
6. We receive the same rebate as OT's, Speech pathologists (who use MS word/consult) - yet incur expenses more comparable with Dentists (dressings/blades/injections etc.) - where's the equity in that?

Are we collectively so desperate that we need to collaborate in a significantly flawed and biased system?

Now, I'll duck for cover as the replies of how 'lucky' we are to be invited, or how the patients suffer if we don't participate etc

 

Outrageous may be one way to describe it - but I can think of several other expletives. Seriously the GP gets paid almost as much to "push the button" as the patient gets across all disciplines for 5 visits a year.

The AMA need to take a long hard look at themselves.....

 

Thank the gods that others see it as I do, did you all know that GP's get paid $50.85 to perform an ABI????????????

 

I could call medicare but you never know if you get the correct response, so I'll ask Pod Arenites;
Are you able to put through a claim for patients on EPC who book and appointment and fail to show (withpout calling or a reasonable excuse?)

I know my patients on EPC are about 4x more likely to no-show than private patients. I beleive it is because they place less importance on your time and service.
Really cheeses me off!

 

Dear Melb Pod,

Way to go.

Low cost equals low value hence DNA rate is appalling.

I say bill the iliigitimate expletive deleted.:butcher:

I personally am sick of the conduct of Medicare Pts.:bang:

We could raise the charge to Meducare pts to 100.00. They would still get their 48.95 rebate and we would a decent fee which represents the stress and hassle we have to put up with when dealing with this client group.

An other point is how many EPC referrals from the GP's comply with the guidelines. IMHO about 30% of all referrals.

The 70% are just not at risk non essential palliative care on the cheap.

I do believe that when they look at how this is being abused by the pt base and GP's they will kill it.

We will be left with 10 dollar pts who will not pay a realistic fee structure commensurate with our skills and expertise.:deadhorse:

Ho Hum

Another day on the ranch tomorrow.

David:drinks